Provider Demographics
NPI:1427075159
Name:ROZEN, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:ROZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10901 REED HARTMAN HWY
Mailing Address - Street 2:SUITE 223
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-2831
Mailing Address - Country:US
Mailing Address - Phone:513-984-2435
Mailing Address - Fax:
Practice Address - Street 1:10901 REED HARTMAN HWY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-2831
Practice Address - Country:US
Practice Address - Phone:513-984-2435
Practice Address - Fax:859-818-6220
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3530165R173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35030165ROtherMEDICAL LICENSE